Air District Complaint

You may use the form below to submit your air quality compliant. The District will initiate an investigation within 24 hours of receipt your complaint information. Please provide your name, address, phone number, and e-mail if you wish to receive feedback from the District about your complaint. The District may need to contact you to request and/or provide additional information. Your contact information is kept confidential. The District will contact you after the investigation is completed. The time may vary depending upon the nature of the investigation and information provided.

Please be aware that the present Internet problem of e-mail "spam" may slow the delivery of e-mail. You may contact the District at 209/257-0112 to verify that your complaint is received.

Fields marked with the * are required.

Part I - Your Information

1

Part I - Your Information

Part I - Your Information

First Name

Last Name

Address

City

State

Phone Numberext.

Email Address

Part II - About the Complaint

2

Source of Problem (Name of Company, if applicable)

*

Source of Problem (Name of Company, if applicable)

Source of Problem (Name of Company, if applicable)

Location of Source (Address, if possible)

Description of Complain

Comments

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Email Address

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